Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 32856 | OK |
NPI | 1144517103 |
---|---|
Provider Name | Dr. Shauna Marie Lawlis |
First Address | Oklahoma City, OK 73117-1039 |
Second Address | Oklahoma City, OK 73104-4637 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2011 |
Last Update Date | 16/03/2021 |